41 research outputs found
A tĂĽdĹ‘rák hazai epidemiolĂłgiai adatai Ăşj megközelĂtĂ©sben
In the international publications, in the last decades, incidence and mortality of lung cancer was the highest in Hungary in the ranking of European countries and even worldwide, despite the fact that no lung cancer incidence data were reported from Hungary until 2019. In the studies published by our working group at the end of 2019 and in the first half of 2020, we were the first to publish Hungarian lung cancer incidence and mortality data based on research on the NEAK database. The results of this study showed a significant, 25-30% lower incidence of lung cancer in Hungary than the previously reported data. Based on these findings, it was determined that the previously reported Hungarian lung cancer incidence and mortality data can be compiled due to different methodological applications of inadequately calculated results, and Hungarian lung cancer incidence and mortality are equally high, but not higher than the average in Central European countries. In addition, a decrease in the incidence and mortality of male lung cancer was measured between 2011 and 2016, while increasing values were found for women
Circulating endothelial cells, bone marrow-derived endothelial progenitor cells and proangiogenic haematopoietic cells in cancer: From biology to therapy
Vascularization, a hallmark of tumorigenesis, is classically thought to occur exclusively through angiogenesis (i.e. endothelial sprouting). However, there is a growing body of evidence that endothelial progenitor cells (EPCs) and proangiogenic hematopoietic cells (HCs) are able to support the vascularization of tumors and may therefore play a synergistic role with angiogenesis. An additional cell type being studied in the field of tumor vascularization is the circulating endothelial cell (CEC), whose presence in elevated numbers reflects vascular injury. Levels of EPCs and CECs are reported to correlate with tumor stage and have been evaluated as biomarkers of the efficacy of anticancer/antiangiogenic treatments. Furthermore, because EPCs and subtypes of proangiogenic HCs are actively participating in capillary growth, these cells are attractive potential vehicles for delivering therapeutic molecules. The current paper provides an update on the biology of CECs, EPCs and proangiogenic HCs, and explores the utility of these cell populations for clinical oncology
Antivirális és gyulladásellenes kezelési lehetőségek COVID–19-ben
Ă–sszefoglalĂł. Az Ăşj tĂpusĂş koronavĂrus-fertĹ‘zĂ©s (COVID-19) nagy terhet rĂł az egĂ©szsĂ©gĂĽgyi ellátĂłrendszerre Ă©s a társadalomra. A betegsĂ©gnek három nagy szakasza van, melyek alapvetĹ‘en meghatározzák a kezelĂ©st. Az I-IIA fázisban az antivirális, mĂg a IIB-III. fázisban a gyulladásgátlĂł kezelĂ©s áll elĹ‘tĂ©rben, melyhez intenzĂv terápiás, szupportĂv kezelĂ©s csatlakozik. A jelen ajánlás kizárĂłlag a gyĂłgyszeres kezelĂ©sre vonatkozik, Ă©s a rendelkezĂ©sre állĂł bizonyĂtĂ©kok alapján foglalja össze a terápiás lehetĹ‘sĂ©geket. Emellett egy javasolt kezelĂ©si algoritmust is tartalmaz. Orv Hetil. 2021; 162(17): 643-651. Summary. The novel coronavirus infection (COVID-19) places a heavy burden on the health care system and our society. There are three major stages in the disease that fundamentally determine treatment approaches. Phases I-IIA require primarily antiviral treatment. In phases IIB-III, anti-inflammatory treatment is needed accompanied by intensive and supportive care. This recommendation applies only to pharmacotherapy and summarizes the therapeutic options based on the available evidence. It also includes a proposed treatment algorithm. Orv Hetil. 2021; 162(17): 643-651
EGFR T790M Mutation Detection in Patients With Non-Small Cell Lung Cancer After First Line EGFR TKI Therapy: Summary of Results in a Three-Year Period and a Comparison of Commercially Available Detection Kits
EGFR mutation in non-small cell lung cancer (NSCLC) offers a potential therapeutic target for tyrosine kinase inhibitor (TKI) therapy. The majority of these cases, however eventually develop therapy resistance, mainly by acquiring EGFR T790M mutation. Recently, third-generation TKIs have been introduced to overcome T790M mutation-related resistance. Cell free circulating tumor DNA (liquid biopsy) has emerged as a valuable alternative method for T790M mutation detection during patient follow up, when a tissue biopsy cannot be obtained for analysis. In this study, we summarized our experience with Super-ARMS EGFR Mutation Detection Kit (AmoyDx) on 401 samples of 242 NSCLC patients in a 3-year period in Hungary, comprising 364 plasma and 37 non-plasma samples. We also compared the performance of two commercially available detection kits, the cobas EGFR Mutation test v2 (Roche) and the Super-ARMS EGFR Mutation Detection Kit (AmoyDx). The same activating EGFR mutation was detected with the AmoyDx kit as in the primary tumor in 45.6% of the samples. T790M mutation was identified in 48.1% of the samples containing activating EGFR mutation. The detection rate of T790M mutation was not dependent on the DNA concentration of the plasma sample and there was no considerable improvement in mutation detection rate after a second, subsequent plasma sample. The concordance of EGFR activating mutation detection was 89% between the two methods, while this was 93% for T790M mutation detection. The AmoyDx kit, however showed an overall higher detection rate of T790M mutation compared to the cobas kit (p = 0.014). T790M mutation was detected at 29.8% of the patients if only plasma samples were available for analysis, while the detection rate was 70.2% in non-plasma samples. If the activating EGFR was detected in the plasma samples, the detection rate of T790M mutation was 42.4%. Although non-plasma samples provided a superior T790M mutation detection rate, we found that liquid biopsy can offer a valuable tool for T790M mutation detection, when a tissue biopsy is not available. Alternatively, a liquid biopsy can be used as a screening test, when re-biopsy should be considered in case of wild-type results
Revising Incidence and Mortality of Lung Cancer in Central Europe: An Epidemiology Review From Hungary
Objective: While Hungary is often reported to have the highest incidence and mortality rates of lung cancer, until 2018 no nationwide epidemiology study was conducted to confirm these trends. The objective of this study was to estimate the occurrence of lung cancer in Hungary based on a retrospective review of the National Health Insurance Fund (NHIF) database. Methods: Our retrospective, longitudinal study included patients aged ≥20 years who were diagnosed with lung cancer (ICD-10 C34) between 1 Jan 2011 and 31 Dec 2016. Age-standardized incidence and mortality rates were calculated using both the 1976 and 2013 European Standard Populations (ESP). Results: Between 2011 and 2016, 6,996 - 7,158 new lung cancer cases were recorded in the NHIF database annually, and 6,045 - 6,465 all-cause deaths occurred per year. Age-adjusted incidence rates were 115.7-101.6/100,000 person-years among men (ESP 1976: 84.7-72.6), showing a mean annual change of - 2.26% (p = 0.008). Incidence rates among women increased from 48.3 to 50.3/100,000 person-years (ESP 1976: 36.9-38.0), corresponding to a mean annual change of 1.23% (p = 0.028). Age-standardized mortality rates varied between 103.8 and 97.2/100,000 person-years (ESP 1976: 72.8-69.7) in men and between 38.3 and 42.7/100,000 person-years (ESP 1976: 27.8-29.3) in women. Conclusion: Age-standardized incidence and mortality rates of lung cancer in Hungary were found to be high compared to Western-European countries, but lower than those reported by previous publications. The incidence of lung cancer decreased in men, while there was an increase in incidence and mortality among female lung cancer patients
A COVID–19-járvány hatása a leggyakoribb légzőszervi megbetegedések lefolyására
Bevezetés: A SARS-CoV-2 által okozott fertőzés az elmúlt három évben meghatározta mindennapi életünket, és nem
várt terhet rótt az egészségügyi ellátórendszerre, többek között azáltal, hogy komoly kockázati tényezőt jelenthet a
már meglévő, különböző légzőszervi megbetegedésekkel küzdő betegek számára is.
Célkitűzés: A COVID–19 és a fertőzéskor már fennálló légzőszervi megbetegedések, elsősorban a krónikus obstruk-
tĂv tĂĽdĹ‘betegsĂ©g (COPD), valamint az asztma összefĂĽggĂ©seinek feltárása.
MĂłdszer: Hazai vizsgálatunkban közel 29 000 beteg adatait dolgoztuk fel retrospektĂven.
EredmĂ©nyek: EredmĂ©nyeink alapján elmondhatĂł, hogy a COPD mint társbetegsĂ©g meglĂ©te a nemzetközi megállapĂ-
tással egybehangzĂłan összefĂĽggĂ©st mutat a COVID–19-fertĹ‘zĂ©s sĂşlyosságával, illetve enyhĂ©n növeli az intenzĂv osz-
tályos kezelés és a gépi lélegeztetés szükségességének kockázatát a SARS-CoV-2 okozta megbetegedés során. Asztma
esetĂ©ben mindezt nem sikerĂĽlt kimutatnunk, vagyis sem a SARS-CoV-2-fertĹ‘zĂ©s sĂşlyosságát, sem az intenzĂv osztá-
lyos kezelés és a gépi lélegeztetés szükségességét nem befolyásolta jelentősen az asztma mint társbetegség megléte.
MegbeszĂ©lĂ©s: Ahogy nemzetközi tanulmányokban is olvashatĂł, a COPD mint társbetegsĂ©g meglĂ©te nem növeli jelentĹ‘s mĂ©rtĂ©kben a SARS-CoV-2-fertĹ‘zĂ©s kockázatát. Ugyanakkor kijelenthetĹ‘, hogy a COPD növeli a COVID–19-pozitĂv betegek kĂłrházba kerĂĽlĂ©sĂ©nek esĂ©lyĂ©t, Ă©s emeli a megbetegedĂ©s sĂşlyosabb lefolyásának valĂłszĂnűsĂ©gĂ©t. Tekintettel a COPD-betegekben a tĂĽdĹ‘ károsodása során vĂ©gbemenĹ‘ szerkezeti átĂ©pĂĽlĂ©sre Ă©s rendellenes regenerálĂłdási folyamatokra, e betegek a vĂrusfertĹ‘zĂ©s lezajlása után fokozott odafigyelĂ©st, valamint szemĂ©lyre szabott rehabilitáciĂłt igĂ©nyelnek.
KövetkeztetĂ©s: Ă–sszessĂ©gĂ©ben elmondhatĂł, hogy a jövĹ‘ben a szemĂ©lyre szabott terápiás megközelĂtĂ©s bevezetĂ©sĂ©hez
elengedhetetlen a kĂĽlönbözĹ‘ COPD-s fenotĂpusok (valamint egyĂ©b krĂłnikus tĂĽdĹ‘betegsĂ©gek) Ă©s a SARS-CoV-2-fer-
tőzés klinikai megnyilvánulásainak mélyreható vizsgálata
Revising Incidence and Mortality of Lung Cancer in Central Europe: An Epidemiology Review From Hungary
Objective: While Hungary is often reported to have the highest incidence and mortality rates of lung cancer, until 2018 no nationwide epidemiology study was conducted to confirm these trends. The objective of this study was to estimate the occurrence of lung cancer in Hungary based on a retrospective review of the National Health Insurance Fund (NHIF) database. Methods: Our retrospective, longitudinal study included patients aged ≥20 years who were diagnosed with lung cancer (ICD-10 C34) between 1 Jan 2011 and 31 Dec 2016. Age-standardized incidence and mortality rates were calculated using both the 1976 and 2013 European Standard Populations (ESP). Results: Between 2011 and 2016, 6,996 - 7,158 new lung cancer cases were recorded in the NHIF database annually, and 6,045 - 6,465 all-cause deaths occurred per year. Age-adjusted incidence rates were 115.7-101.6/100,000 person-years among men (ESP 1976: 84.7-72.6), showing a mean annual change of - 2.26% (p = 0.008). Incidence rates among women increased from 48.3 to 50.3/100,000 person-years (ESP 1976: 36.9-38.0), corresponding to a mean annual change of 1.23% (p = 0.028). Age-standardized mortality rates varied between 103.8 and 97.2/100,000 person-years (ESP 1976: 72.8-69.7) in men and between 38.3 and 42.7/100,000 person-years (ESP 1976: 27.8-29.3) in women. Conclusion: Age-standardized incidence and mortality rates of lung cancer in Hungary were found to be high compared to Western-European countries, but lower than those reported by previous publications. The incidence of lung cancer decreased in men, while there was an increase in incidence and mortality among female lung cancer patients
Increase in the Length of Lung Cancer Patient Pathway Before First-Line Therapy : A 6-Year Nationwide Analysis From Hungary
Objective: This study aimed to examine the characteristics of the lung cancer (LC) patient pathway in Hungary during a 6-years period. Methods: This nationwide, retrospective study included patients newly diagnosed with LC (ICD-10 C34) between January 1, 2011, and December 31, 2016, using data from the National Health Insurance Fund (NHIF) of Hungary. The following patient pathway intervals were examined: system, diagnostic and treatment interval by age, gender, tumor type, study year and first-line LC therapy. Results: During the 6-years study period, 17,386 patients had at least one type of imaging (X-ray or CT/MRI) prior to diagnosis, and 12,063 had records of both X-ray and CT/MRI. The median system interval was 64.5 days, and it was 5 days longer among women, than in men (68.0 vs. 63.0 days). The median system interval was significantly longer in patients with adenocarcinoma compared to those with squamous cell carcinoma or small cell lung cancer (70.4 vs. 64.0 vs. 48.0 days, respectively). Patients who received surgery as first-line treatment had significantly longer median system intervals compared to those receiving chemotherapy (81.4 vs. 62.0 days). The median system interval significantly increased from 62.0 to 66.0 days during the 6-years study period. Conclusion: The LC patient pathway significantly increased in Hungary over the 6-years study period. There were no significant differences in the length of the whole LC patient pathway according to age, however, female sex, surgery as first-line treatment, and adenocarcinoma were associated with longer system intervals
Age and Gender Specific Lung Cancer Incidence and Mortality in Hungary: Trends from 2011 Through 2016
Objective: No assessment was conducted describing the age and gender specific epidemiology of lung cancer (LC) prior to 2018 in Hungary, thus the objective of this study was to appraise the detailed epidemiology of lung cancer (ICD-10 C34) in Hungary based on a retrospective analysis of the National Health Insurance Fund database. Methods: This longitudinal study included patients aged ≥20 years with LC diagnosis (ICD-10 C34) between January 1, 2011 and December 31, 2016. Patients with different cancer-related codes 6 months before or 12 months after LC diagnosis or having any cancer treatment other than lung cancer protocols were excluded. Results: Lung cancer incidence and mortality increased with age, peaking in the 70–79 age group (375.0/100,000 person-years) among males, while at 60–69 age group for females (148.1/100,000 person-years). The male-to-female incidence rate ratio reached 2.46–3.01 (p 60) annually during the study period. Conclusion: This nationwide epidemiology study demonstrated that LC incidence and mortality in Hungary decreased in younger male and female population, however we found significant increase of incidence in older female population, similar to international trends. Incidence rates peaked in younger age-groups compared to Western countries, most likely due to higher smoking prevalence in these cohorts, while lower age LC incidence could be attributed to higher competing cardiovascular risk resulting in earlier mortality in smoking population